Putting blood pressure in its place

The benefit of blood pressure-lowering therapy in individuals with normal blood pressure who are at high cardiovascular risk creates a challenge in how best to advocate such therapy. Arguments based on a putative causal role for blood pressure and the need to reduce blood pressure may be less likely to succeed than arguments based on the need to prevent and to reverse the cardiovascular disease that causes cardiovascular events.     

Some things have not changed

The profession of medicine faces unprecedented pressures that jeopardize physicians' ability to care for patients. This is the perfect time for physicians to look back at the history of medicine; examine our own personal journeys; and reflect on our ideals, commitments, and accomplishments. To be effective leaders for medicine and health, physicians must work together. We must be vigilant about threats to high standards, research, education, and ethics and seize opportunities for improvement. We need to ensure that relationships with patients, students and housestaff, and other colleagues are marked by trust and healing. The days, years, and careers that we spend caring for others are most sustainable and satisfying if we also care for ourselves and our families. Many elements are required for physicians to maintain the lifegiving capabilities of our profession. Principles and thought combined with action have carried and buoyed medicine throughout time. This must not change.